MTM Flashcards
1
Q
What is MTM?
A
Patient-centric and comprehensive approach to improve medication use, reduce the risk of adverse events and improve medication adherence.
Defined by the Centers for Medicare and Medicaid Services (CMS)
2
Q
National Trend
A
- Quality over Quantity
- Pay for performance
- Value based purchasing
- Prescription drug plans MUST have MTM program
- Geared towards “target beneficiaries”
3
Q
Medicare Part D Star Rating Domains
A
- Approriate use of medications in high risk and elderly
- Adherence to DM medications
- Adherence to RAS antagonists
- Adherence to statins
- Use of renin-angiotensin system (RAS) antagonist in diabetes patients with HTN
4
Q
Targeted Beneficiary Requirements
A
- Mutliple chronic conditions (3+)
- Must take multiple Part D medications (Cannot require more than 8 as minimum)
- High drug costs ($3138 for 2015)
5
Q
Required MTM Services
A
- Interventions for beneficiaries and prescribers
- Annual comprehensive medication review (CMR)
- Quarterly targeted medication review (TMR)
6
Q
CMR
A
- Develop prioritized list of medication-related problems
- Improve knowledge of prescriptions, OTC, herbals/supplements, identify and address problems or concerns, empower patients to self manage
7
Q
TMR
A
- Assess medication use
- Monitor unsolved issues
- If new drug therapy problems, assess if has experienced transition in care
- Focused on specific actual or potential medication related problems.
8
Q
TMR and MRP
A
- Focus on a single Medication Related Problem (MRP)
- Unnecessary therapy
- Additional therapy needed
- Ineffective
- Dose
- ADA
- Adherence
- Cost
9
Q
Steps to Addressing TMRs
A
-
Reason for intervention
- Identify MRP
- Rational/clinical evidence for intervention
-
Action
- What questions need to be asked?
- What do you recommend
-
Result
- Doccument outcome after action taken
- Follow up plans
10
Q
TMR Tips
A
- Communicate with patient before prescriber
- Align yourself with your patient
- Use communication tools
- SBAR
11
Q
Core Elements of CMR
A
- Medication Therapy Review
- Personal Medication Record
- Medication Action Plan
- Intervention or Referral
- Doccumentation and Follow Up
12
Q
Items in Personal Medication Record
A
- Patient Name/DOB
- Immunizations
- Allergies
- Drug name/dose
- Indication
- Direction
- Prescriber
- Notes/special instructions
- Ideally one page
13
Q
Three Steps in CMR
A
- Purpose: Resolve MRP identified
- Goals: Prioritize MRPs based on patients goals
- Review Medication Use: Develop an action plan
14
Q
CMR Work through
A
- Generate a list or MRPs
- Prioritize MRPs
- Develop Medication Action Plan (MAP)
- What we talked about
- What I need to do
- What I did and when I did it
- Intervention or Referral
- Documentation and Follow Up
15
Q
MTM Reimbursment
A
- CMR: $60-75/case
- TMR: $10-20/case
- MTM Platforms are used for billing, documentation, quality measures, and data collection
